Achilles Tendonitis - post-operative coursePost Operative Course Following Achilles Tendonitis Surgical TreatmentThe First 24 Hours
- Pain Relief
When you wake up after the operation you will be comfortable having been given an ankle block and local anaesthetic wound infiltration. You will have a regular course of three different pain killers which will be supplied as soon as you are tolerating fluid. The pain is generally moderate and short lived after this procedure lasting 24 to 36 hours.
- Plaster Cast
A lightweight plaster cast will be applied after the operation and this will be split into a front and back section whilst you are asleep to allow your limb to swell.
You will need to keep your cast and the wounds entirely dry following surgery. When showering post-operatively you will need to have your cast in a bag with tape around the top or to use a limbo type cast covering.
- DVT Prophylaxis
You will receive an injection of a low molecular weight Clexane prior to the onset of your operation. You will be instructed how to self-administer a once a day injection with a small volume of low molecular weight Clexane for two weeks following your surgery.
- Length of Stay
On average you will require one day post-operatively in the hospital.
You will be mobilised on the day of surgery or the day following surgery. You will be taught the use of crutches and you will be non-weight bearing for the first three weeks following surgery.
You will be advised to elevate your leg for the first few days following the operation. This means having it on a pillow in bed at night and when sitting at home, having it up on the couch next to you rather than hanging down as normal.
Two Weeks Following Tendon Debridement
At two weeks your cast will be removed and your wounds checked to ensure that they are healing well. A complete lightweight cast will be placed below the level of your knee. You will be instructed to commence light partial weight bearing at three weeks following the date of your surgery. You will be advised to progressively increase the weight which is being placed through the cast until you reach six weeks post-operatively when you should just be achieving full weight bearing.
At Six Weeks Post-Operatively
At six weeks following your Achilles tendon debridement your cast will be removed and you will be instructed on increasing your weight bearing out of cast. Generally this will mean either using a lightweight walking boot or an Achilles Aircast walking boot. Generally you may need to use crutches for a few days having come out of your cast and gone into the removable device.
You will be advised to avoid heavy impact type activities and sports for three months post-operatively. You may return to swimming and cycling type activities as soon as you are comfortable. The chance of success following surgery is in the region of 80-90%.
Complications Following Debridement of Achilles Tendonitis/Tendonosis
- Partial/no resolution of symptoms - 5–15%
- Recurrence of symptoms - 10%
- Wound problems - 1-2% : delayed healing, wound breakdown, scar sensitivity, adhesion of scars attendant
- Deep vein thrombosis/pulmonary embolus – 0.5%
- Wound infection – 1%
- Delayed return to function/activities
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